According to the National Medical Expenditure Survey of 1987, 90 million Americans suffer from one or more chronic conditions. Treatment of these chronic conditions represents over 76% of health care expenditures and the total direct costs of treating these chronic conditions is estimated to rise to $798 billion by the year 2030.
Many patients with chronic conditions are treated at home. Unfortunately, many patients may be unable to reliably manage their treatment, such as medication regimens, at home without the supervision of a healthcare provider. To be effective, medications often must follow various scheduling and dietary guidelines. For example, some medications are to be taken with food, others are not. Some medications are to be taken only once a day, others multiple times per day. Remembering when to take a medication and how much of it can become difficult as the number of concurrent medications increases.
Various devices for assisting patients in following medication regimens are known. For example, U.S. Pat. No. 4,837,719 to McIntosh describes a medication clock for signaling the times that dosages of a medication should be taken. The McIntosh device also provides a record of when each medicine was taken for comparison with the medication schedule. In addition, the McIntosh device can monitor and record temperature, blood pressure and pulse rate of the user.
U.S. Pat. No. 5,020,037 to Raven discloses an alarm pill box which cancels the alarm when a compartment lid is opened. A visual display is used to indicate the number of times that the lid has been opened within one day.
U.S. Pat. No. 4,911,327 to Shepherd et al., describes a dispenser for providing scheduled dosages of pills according to a predetermined medication program. A housing contains a plurality of pill containers from which dosages of pills may be released into a user-accessible pill receiver. The release of pills is controlled such that pills are released at predetermined intervals as dictated by the medication program. On release of a dosage of pills, an alarm is activated to indicate to a user that a dosage is due to be taken, the alarm being deactivated when the user accesses the pill receiver to remove the dosage of pills. If the user does not access the pill receiver within a predetermined time interval from release of the dosage, an optional remote alarm may be activated to alert a supervisor.
U.S. Pat. No. 4,616,316 to Hanpeter et al. describes a medication compliance monitoring system consisting of a blister pack having an array of plastic blisters defining compartments for medication. The blister pack has a frangible non-conductive backing sheet including conductive traces behind the compartments which are respectively ruptured when the medication doses are removed. An electronic memory circuit detects when individual compartments are ruptured and stores this information.
U.S. Pat. No. 5,408,443 to Weinberger describes a medication-dispensing system that includes a prescribing data entry station for use by a physician to store prescription information in a portable prescribing module, a dispensing data entry station for use by a pharmacy to store dispensing information in a portable dispensing data storage unit, and a medication dispenser responsive to information stored in the portable prescribing module to describe use of medication in the dispenser in accordance with a regimen prescribed by the physician and to the dispensing data storage unit to control dispensing of the medication. One embodiment has two medication drawers, each having a plurality of compartments with indicating lights selectively indicating the compartment from which medication is to be taken, a screen for displaying instructions regarding loading of the medication compartments and taking of the medication, and a keyboard including a confirming entry key for actuation by the user to confirm compliance with the instructions. Another embodiment has a series of medication-containing compartments, each covered by a separate sliding or folding cover.
U.S. Pat. No. 5,239,491 to Mucciacciaro describes a holder having a plurality of recesses for holding a plurality of medication containers, each fitting into a unique recess. The geometry of the bottom of each medication container is unique and only matches one recess in the holder. A sensor in each recess signals the presence or absence of the dedicated container to a microprocessor. The microprocessor is programmed with the prescribed dose administration schedule for each of the different medications in the different containers. A real time clock cooperates with the microprocessor and the program to signal audibly and visibly by a light at the appropriate container when a particular pill is to be administered. The signals stop when the appropriate container is removed from its recess. A different, warning sound indicates when the wrong container is lifted.
E-pill (www.epill.com) offers a pager system that sends reminders to patients to take their medication at specific times of the day. Carebridge (www.carebridge.net) provides an electronic timing device that patients can use to help them to remember to take their medication.
IBV Technologies (1500 Westlake Avenue North, Seattle, Wash. 98109) provides a medication vial that records the time a patient takes his/her medication when a button is pressed by the patient. When returned to a pharmacy for a refill, the pharmacy can download and review a compliance report from the vial and counsel the patient regarding medication compliance.
APREX (30112 Eigenbrodt Way, Union City, Calif.) provides a telemedicine service for monitoring medication compliance. Patients take their medication from medication containers outfitted with caps that have a mini-computer therein. When patients remove the cap from a bottle to take a dose of the medication contained therein, the mini-computer records the time and date of the dosing event. At the end of the day, patients place their medication bottles on a specially configured modem that transmits daily dosing information to a selected healthcare provider. If the healthcare provider detects a problem in how or when patients are taking their medication, those patients are called the next day by specially trained healthcare providers.
The MediMonitor.RTM., available from InforMedix, Inc. (5920 Hubbard Dr., Rockville Md. 20852), is configured to retain a month's supply of up to five medications in individual compartments and alerts patients when and how to take the medications. The MediMonitor.RTM. also monitors medication use and health status by providing a date and time-stamped record of a patient's medication-taking behavior, together with patient responses to specific questions. The MediMonitor.RTM. can transmit information via an Internet-accessible server and database to clinical drug trial sites, physicians, pharmacies and other healthcare providers. Healthcare providers can communicate information, as well as reminders and specific instructions, directly to patients via the MediMonitor.RTM..
Szeto et al. describe a holder having receptacles for five standard sized medication containers, a four-line 20-character alphanumeric LCD, and connectors for power supply and data communications. A microswitch embedded in a wall of each receptacle detects whether the receptacle is occupied or empty.
Unfortunately, existing devices for assisting patients in following medication regimens can be somewhat expensive and complex in design. Furthermore, existing devices for assisting patients in following medication regimens can seem somewhat intrusive to a user.